If you have been diagnosed with uterine fibroids, you may have been told that surgery is your only option. For many women, that means either a hysterectomy — the removal of the uterus — or a myomectomy, which removes the fibroids while preserving the uterus. Both involve general anaesthesia, a hospital stay, and a recovery period of several weeks.
What many patients are not told is that there is a highly effective, clinically proven, non-surgical alternative: Uterine Fibroid Embolisation (UFE). This minimally invasive procedure is performed by an interventional radiologist — not a surgeon — and can treat fibroids without a single incision.
Dr. AbdulRahman Alvi, a UK-trained Consultant Interventional Radiologist, has helped hundreds of women avoid surgery through UFE. In this guide, he explains the key differences between UFE and surgery, and how to determine which option is right for you.
What Are Uterine Fibroids?
Uterine fibroids (also known as leiomyomas or myomas) are non-cancerous growths that develop in or around the uterus. They are extremely common — affecting up to 70% of women by the age of 50 — and can vary enormously in size, number, and location.
While many fibroids cause no symptoms at all, others lead to:
- Heavy, prolonged, or painful menstrual bleeding
- Pelvic pressure, bloating, or pain
- Frequent urination or difficulty emptying the bladder
- Pain during sexual intercourse
- Anaemia caused by excessive blood loss
- Difficulties with fertility or pregnancy
The location and size of the fibroids largely determine which treatment is most appropriate.
What is Uterine Fibroid Embolisation (UFE)?
UFE is a minimally invasive procedure performed by an interventional radiologist under local anaesthesia. Using real-time X-ray imaging (fluoroscopy) as guidance, the doctor inserts a tiny catheter — a thin flexible tube — through a small puncture in the wrist or groin and navigates it to the uterine arteries that supply blood to the fibroids.
Tiny particles called embolic agents are then released into these arteries, cutting off the blood supply to the fibroids. Deprived of blood, the fibroids gradually shrink — typically by 50–60% within three to six months — and the symptoms they caused resolve accordingly.
UFE is performed under local anaesthesia, requires no surgical incisions, and most patients return home the same day or within 24 hours.
What to Expect During and After UFE
- A small skin puncture (2mm) is made at the wrist or groin — no stitches required.
- The procedure takes approximately 60–90 minutes under light sedation.
- Patients typically experience cramping in the first 12–24 hours as fibroids begin to lose their blood supply — this is managed with pain relief.
- Most patients go home the same day or the following morning.
- Full recovery usually takes 7–10 days, with most women returning to work within 1–2 weeks.
- Fibroids continue shrinking over 3–6 months, with symptoms improving progressively.
What Does Fibroid Surgery Involve?
Surgical treatment for fibroids comes in two main forms:
1. Hysterectomy (Removal of the Uterus)
A hysterectomy is the only permanent cure for fibroids and eliminates any possibility of recurrence. However, it also means the permanent loss of the uterus — making pregnancy impossible afterwards. It involves general anaesthesia, a hospital stay of 3–5 days, and a recovery period of 6–8 weeks.
2. Myomectomy (Removal of Fibroids, Uterus Preserved)
A myomectomy removes individual fibroids while leaving the uterus intact — preserving fertility. However, it carries a recurrence risk of up to 30% within 5 years, particularly for women with multiple fibroids. It also requires general anaesthesia and a recovery period of 4–6 weeks.
UFE vs Surgery: A Side-by-Side Comparison
The table below compares UFE with surgical options across the most important factors for patients:
| Factor | Surgery | UFE (Non-Surgical) |
|---|---|---|
| Incision size | Large (5–15 cm) | Tiny (2 mm pinhole) |
| Anaesthesia | General anaesthesia | Local anaesthesia only |
| Hospital stay | 3–5 days | Same day / overnight |
| Recovery time | 6–8 weeks | 7–10 days |
| Fertility preserved | No (hysterectomy) | Yes — uterus intact |
| Recurrence risk | None (uterus removed) | ~20% within 5 years |
| Scar | Visible abdominal scar | Minimal — no scar |
| Blood loss / transfusion | Higher risk | Significantly lower |
| Suitable for | All fibroid types | Most fibroid types |
| Return to work | 4–6 weeks | 1–2 weeks |
Who is UFE Right For?
UFE is suitable for the majority of women with symptomatic uterine fibroids who wish to avoid surgery. You may be an ideal candidate if you:
- Are experiencing heavy menstrual bleeding, pelvic pain, or pressure symptoms caused by fibroids
- Wish to preserve your uterus and avoid a hysterectomy
- Are not a candidate for general anaesthesia due to other health conditions
- Want a shorter recovery time and less time away from work or family
- Have already tried hormonal therapy with limited success
- Are approaching or post-menopause and want a non-surgical solution
UFE is generally not recommended for women who are pregnant, have active pelvic infection, or whose fibroids are located in areas that do not have a suitable blood supply for embolisation. A detailed consultation is essential to determine your individual suitability.
Who is Surgery Right For?
In some cases, surgery remains the more appropriate choice. Surgical treatment may be recommended if you:
- Have very large fibroids (greater than 10 cm) that are causing significant structural problems
- Have fibroids in a submucosal location that are best treated by hysteroscopic resection
- Wish to have a definitive cure with no risk of recurrence (hysterectomy)
- Have fibroids alongside other gynaecological conditions that also require surgical treatment
- Have received an inconclusive diagnosis and require a tissue biopsy
What Does the Evidence Say?
UFE is a well-established, evidence-based treatment with over 25 years of clinical data supporting its safety and effectiveness. Key findings from clinical studies include:
- 90% of patients report a significant improvement in symptoms following UFE
- Fibroid volume reduces by an average of 50–60% within 6 months of the procedure
- Patient satisfaction rates are consistently high, with most women reporting improved quality of life
- UFE has a lower rate of major complications compared to hysterectomy
- The procedure preserves the uterus in 98% of patients who undergo it
Both the Royal College of Obstetricians and Gynaecologists (RCOG) and the National Institute for Health and Care Excellence (NICE) recognise UFE as a safe and effective alternative to surgery for suitable patients.
Making the Right Choice for You
The decision between UFE and surgery is deeply personal and depends on your individual circumstances — including the size, number, and location of your fibroids, your symptoms, your fertility goals, and your general health.
There is no single answer that is right for everyone. What matters most is that you are fully informed about all available options before making a decision. A specialist consultation with an interventional radiologist is an important step — one that many women are not offered before being referred directly to surgery.
“Every woman deserves to know that a non-surgical option exists before agreeing to go under the knife. My goal in every consultation is to make sure patients are empowered with the full picture.” — Dr. AbdulRahman Alvi
Book a Free Consultation with Dr. AbdulRahman Alvi
Unsure whether UFE or surgery is right for you? Dr. Alvi offers a detailed, no-obligation consultation to review your scans, discuss your symptoms, and recommend the most appropriate treatment for your individual situation.
📍 King’s College Hospital Dubai
📞 +971 55 771 8980
✉ info@drarjalvi.com